Navigating the Pillars of the ACA - How ADP Can Help
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Transcript of Navigating the Pillars of the ACA - How ADP Can Help
Navigating the Pillars ofthe Affordable Care Act
2
50Employers with at least 50 full-time employees will be required to pay a penalty if they fail to offer minimum essential coverage & a full-time employee obtains subsidized coverage from an exchange
60Employers may be subject to a penalty if it decides to play because the coverage offered is either “unaffordable”
or the plan is not designed to pay at least 60% of participants’ covered medical expenses
90 Employers have only 90 days to offer eligible employees health care benefits
What Do These Numbers Represent?
3
Three Things You Will Remember
! WHY IT’S IMPORTANT TO YOU
+ HOW ADP CAN HELP
? WHAT IS THE BUSINESS ISSUE?
WHAT IS THE BUSINESS ISSUE? ?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.4
eligibility risk
Schedule and manage hours of service to
minimize
WORKFORCE PLANNING
ACA liability
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.5
HOW ADP CAN HELP+
Reports are provided for illustration purposes and are subject to change
Use the hours summary reports on a weekly and annual basis to determine whether schedule adjustments should be made for employees
Workforce Planning
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.6
HOW ADP CAN HELP+
Seamless integration of Time & Attendance with Payroll and HR allows access to a list of ACA eligible employees for improved scheduling and ACA benefits cost control
Workforce Planning
Automated scheduling makes it easy to identify when employees are approaching the ACA benefits threshold and adjust the schedule
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.7
WHY IT’S IMPORTANT!
Empowers you to be proactive in controlling benefit eligibility
Minimizes your ACA liability
Aids in aligning labor with demand to reduce costs without compromising customer satisfaction
Workforce Planning
WHAT IS THE BUSINESS ISSUE?
ELIGIBILITY
Accurately determine employee eligibility &
assessment
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.8
method(s)
PART-TIME
FULL-TIME
9
Ability to categorize workforce and establish measurement/look-back periods to meet your business requirement
Provides automation of measurement periods. This includes Standard, Administrative, & Stability periods for multiple Employee categories
HOW ADP CAN HELP+Eligibility Tools
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Ability to pull total hours for each employee to use in the determination of full time equivalency qualification for ACA
Provides ACA Benefit Status with the option to “Change” if they are not confident in their calculations
HOW ADP CAN HELP+Eligibility Tools
Provides ACA Benefit Status with the option to “Change” if they are not confident in their calculations.
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HOW ADP CAN HELP+Eligibility Tools
Eligibility Report provides an easy way to look at employee base as a whole and identify who has reached eligibility requirements
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.12
WHY IT’S IMPORTANT!
Enables fair and consistent measurement/look-back periods for all employees
Minimize costs without compromising productivity and service
Helps you comply with government requirements & regulations
Eligibility
PART-TIME
FULL-TIME
WHAT IS THE BUSINESS ISSUE?
AFFORDABILITY
Select affordability assessment method; Employee premium
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.13
of Box 1 W-2 earnings not to exceed
W-2
%9.5
W-2
14
HOW ADP CAN HELP+Affordability Tools
Provide tools for the practitioner to conduct analysis of employees purchasing employee only coverage compared to 9 ½% of earnings
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.15
HOW ADP CAN HELP+Affordability – Health Insurance
Costs for the W-2
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.
ADP gives the ability to determine which benefit plans should be included in the Group Health Insurance Costs calculation for the W-2
16
HOW ADP CAN HELP+Affordability Tools
Assist with identifying plans that are minimum essential coverage (60%+ of actuarial value)
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.17
WHY IT’S IMPORTANT!
Mitigates risk related to cost of benefits and employee burden levels
Aids in evaluating affordability and minimizes potential penalties to employer
Reduces administration burden in determining wage levels
Affordability
W-2
%9.5
W-2
WHAT IS THE BUSINESS ISSUE?
ENROLLMENT
Manage end-to-end enrollment of eligibleemployees
“Play or Pay”
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.18
Allows employees to opt out of medical plan with required reason to ensure employer has appropriate tracking and auditing tools
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HOW ADP CAN HELP+Enrollment Tools
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HOW ADP CAN HELP+Enrollment Tools
Provides tools to assist with the annual reconciliation of the penalty bill against benefits and W-2 data, enabling client to request W-2 corrections or initiate penalty appeals process
Comprehensive report with employees’ plan enrollment details.
HOW ADP CAN HELP+Enrollment Tools
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Comprehensive report with employee and dependent plan enrollments; including auditing data like age limit and overage dependent details
Provides proactive report to show employee enrollment status ensuring Employers take action during their Administrative period.
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HOW ADP CAN HELP+Enrollment Tools
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.23
WHY IT’S IMPORTANT!
Empowers employees with ability to select appropriate plans for lifestyle
Communicates to employer why employee has opted out of benefits
Helps mitigate potential penalties to the employer
Enrollment
WHAT IS THE BUSINESS ISSUE?
AUDITING & REPORTING
Standard compliance reports for the
Affordable Care Act
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.24
REPORT
HOW ADP CAN HELP+Standard Compliance Reports
25
Group Health Insurance Costs reporting is available to generate and review the costs associated with each employee by benefit plan
HOW ADP CAN HELP+
Manage end-to-end enrollment of eligible employees with comprehensive enrollment details on employees & dependents
Play or Pay Preparation Report
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HOW ADP CAN HELP+
ADP provides Practitioners with self administered plans the means to calculate the research fee
Patient –Centered Outcomes Research Fee Report
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Patient-Centered Outcomes Research Fee report provides the detailed information on fees owed by each benefit plan provider towards the Patient-Centered Outcomes Research
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.28
WHY IT’S IMPORTANT!Auditing & Reporting
Aids ACA compliance efforts to government agencies
Improves accuracy and reduces risk of penalties
Reduces administrative burden of ACA auditing and reporting
REPORT
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Of the Affordable Care Act
ADDITIONAL PROVISIONS
Source: Mercer Select Health Care Reform Briefing, October 27, 2011
WHAT IS THE BUSINESS ISSUE?
DEPENDENT COVERAGE
Employers must expand coverage for qualifying dependent children
up to age 26
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.30
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.31
Ability to configure ADP platform to apply age rules where applicable
Provide open and life event enrollment tools to allow dependent children up to age 26 access to health and welfare plans
Provide benefit plan setup template to track dependent age requirements
HOW ADP CAN HELP+Dependent Coverage
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.32
Reduces costs associated with ineligible plan participants
Reduces premium overpayments
Helps ensure compliance with coverage regulations
WHY IT’S IMPORTANT!Dependent Coverage
WHAT IS THE BUSINESS ISSUE?
Insurers and self-insured group health plans must provide SBCs for annual enrollments beginning on or after
9/23/12+
BENEFITS
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.33
SUMMARY OF BENEFITS AND COVERAGE (SBC)
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.34
ADP supports delivery of SBC electronically as well as obtaining acknowledgement from employees; client can also print hard copy
HOW ADP CAN HELP+Summary of Benefits and
Coverage (SBC)
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.35
WHY IT’S IMPORTANT!
Aids compliance with SBC requirements
Reduces administrative burden of communicating SBCs to employees
Empowers employees with access to coverage-related information
+BENEFITS
Summary of Benefits and Coverage (SBC)
WHAT IS THE BUSINESS ISSUE?
FSA ANNUAL LIMIT
maximumAbility to determine the
amount an employee can contribute to FSA
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.36
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.37
HOW ADP CAN HELP+
Provide one- stop shop for all ADP Healthcare spending accounts for 2013 open enrollment (FSA, HSA, HRA), including single debit card and mobile access
FSA Annual Limit
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.38
WHY IT’S IMPORTANT!
Aids compliance with FSA requirements
Reduces administrative burden of communicating FSA limits to employees
Boosts employee engagement by improving communication
MAXIMUM
FSA Annual Limit
WHAT IS THE BUSINESS ISSUE?
Ability to be notified of new statutory
regulations
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.39
MEDICARE TAX ON WAGES AND UNEARNED INCOME
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.40
HOW ADP CAN HELP+Medicare Tax on Wages and
Unearned Income
ADP allows practitioners to generate a report in order to conduct analysis of payroll & deductions for high-income employees who may meet criteria for the new taxes
Calculates the new Medicare tax for appropriate employees
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.41
WHY IT’S IMPORTANT!
Increases employee satisfaction with highly compensated/executive associates on planning their taxes
Improves accuracy and reduces risk of penalties
Medicare Tax on Wages and Unearned Income
WHAT IS THE BUSINESS ISSUE?
Ability to
load notice describing availability of marketplace/exchange coverage
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.42
EMPLOYEE NOTICE OF MARKETPLACE/EXCHANGE
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.43
ADP supports delivery of Notice of Marketplace/Exchange electronically as well as obtaining acknowledgement from employee; client can also print hard copy
HOW ADP CAN HELP+Employee Notice of Marketplace/
Exchange
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.44
WHY IT’S IMPORTANT!
Aids compliance with marketplace/exchange notice requirements
Reduces administrative burden of communicating marketplace/exchange option to employees
Employee Notice of Marketplace/ Exchange
WHAT IS THE BUSINESS ISSUE?
WAITING PERIODS
Ability to define when an employee is eligible to enroll in employer group health plans
Date of Hire
First of the Month
following Hire DateX number of Days following Date of Hire
?
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.45
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.46
Provide new hire reports (up to 90 days) to validate employment status & change triggers to ensure appropriate benefits enrollment
HOW ADP CAN HELP+Waiting Periods
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.47
WHY IT’S IMPORTANT!
Helps mitigate excessive costs based on employment status
Aids compliance with FLSA rules
Date of Hire
First of the Month following Hire Date
X number of Days following Date of Hire
Waiting Periods
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ADPTime and Labor Management
ADPReporting and Reconciliation
ADPPayroll
ADPBenefits
• Report on Hours of Service including Projected Scheduled Hours
• View & Adjust Work Schedules
• Ability to Set Threshold Notification for Total Hours of Service (January 2014)
• Full – Time Status Reporting
• Auto-enrollment Required in 2015
• Enrollment of Eligible Employees
• Coverage Termination
• W-2 Affordability Calculation
• Data to/from Exchanges
• Reporting to Federal Government
• Reconcile Penalties Levied for Exchange Participation
• Deductions and Other Earnings
• W-2 Earnings
• System of Record for Hours of Service
• Look Back Approach
Workforce Planning
Eligibility &
Enrollment
Reporting/Penalties
Affordability
EMPLOYERS Need an Integrated Approach to Manage the ACA
Why ADP . . .
Our goal is to minimize your administrative burden across the entire spectrum of payroll, tax, HR and benefits, so that you can focus on running your business.
“
#ADPHCM "We're proud of our payroll heritage" but #ADP is much more than payroll today -- global HCM leader in the cloud.NAOMI BLOOM, HCM INDUSTRY ANALYST IN FULL BLOOM
“
With RSM McGladrey and ADP managing our most sensitive business information, I come away each day with a sense of confidence and internal control becauseI am managing the business, not the tasks.MIKE NICHOLAS, CHIEF FINANCIAL OFFICERRSM MCGLADREY
“
“Committed to assisting businesses with increased compliance requirements resulting from rapidly evolving legislation.
© Copyright 2012 ADP, Inc. Proprietary and Confidential Information.
Marketplace Buzz
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